Gallivan Mark, Shah Neha, Flood Jennifer
Emerg Infect Dis. 2015 Mar;21(3):435-43. doi: 10.3201/eid2103.141539.
We conducted a retrospective review of California tuberculosis (TB) registry and genotyping data to evaluate trends, analyze epidemiologic differences between adult and child case-patients with Mycobacterium bovis disease, and identify risk factors for M. bovis disease. The percentage of TB cases attributable to M. bovis increased from 3.4% (80/2,384) in 2003 to 5.4% (98/1,808) in 2011 (p = 0.002). All (6/6) child case-patients with M. bovis disease during 2010-2011 had >1 parent/guardian who was born in Mexico, compared with 38% (22/58) of child case-patients with M. tuberculosis disease (p = 0.005). Multivariate analysis of TB case-patients showed Hispanic ethnicity, extrapulmonary disease, diabetes, and immunosuppressive conditions, excluding HIV co-infection, were independently associated with M. bovis disease. Prevention efforts should focus on Hispanic binational families and adults with immunosuppressive conditions. Collection of additional risk factors in the national TB surveillance system and expansion of whole-genome sequencing should be considered.
我们对加利福尼亚结核病登记处和基因分型数据进行了回顾性研究，以评估趋势、分析牛分枝杆菌病成年和儿童病例患者之间的流行病学差异，并确定牛分枝杆菌病的危险因素。由牛分枝杆菌引起的结核病病例百分比从2003年的3.4%（80/2384）增加到2011年的5.4%（98/1808）（p = 0.002）。2010 - 2011年期间，所有（6/6）患牛分枝杆菌病的儿童病例患者都有1名以上出生在墨西哥的父母/监护人，相比之下，患结核分枝杆菌病的儿童病例患者中有38%（22/58）有这样的情况（p = 0.005）。对结核病病例患者的多变量分析显示，西班牙裔种族、肺外疾病、糖尿病以及除合并感染艾滋病毒外的免疫抑制状况与牛分枝杆菌病独立相关。预防工作应侧重于西班牙裔跨国界家庭和患有免疫抑制状况的成年人。应考虑在国家结核病监测系统中收集更多危险因素并扩大全基因组测序。
